This research project analyses the risk factors that are associated with referral to children’s social care for pregnant women engaging with a specialist drugs and alcohol service in the North of England. A sample of 85 pregnant women was taken, all of whom engaged with the specialist service between January 2008 and January 2010, and all of whom had a baby of at least 3 months old when this project began in April 2010. Of the 85 pregnant women examined 55% (n=47) were referred to social care and 12%(14) of babies were fostered or taken into care within the first 3 months of life. Contingency tables found that lack of family support, criminal justice involvement, cocaine use, poly substance use and illicit use during pregnancy were (statistically) significantly associated with referral to social care. A referral to social care was 5 times more likely if there was Illicit use during pregnancy and having no family support increased the likelihood of being referred to social care by over 3 times. This project highlights the importance of addressing substance misuse and social and family support in pregnancy in the context of socio-economic factors.